Fundamentals of Palliative Care for Student Nurses - Megan Rosser - ebook

Fundamentals of Palliative Care for Student Nurses ebook

Megan Rosser

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Opis

Fundamentals of Palliative Care for Student Nursesis a thorough yet accessible introduction and overview of a keyarea of the nursing programme. This textbook clearly explains thepalliation of symptoms and the social context of death and dying.Engaging with the latest guidelines and curriculum, it highlightsthe practical and communicative skills required for inductionprogrammes and continuing professional development. KEY FEATURES: * A full-colour, student-friendly, introduction to the essentialsof palliative, or end of life care * A topical and timely subject area, explored clearly andconcisely * Full of interactive pedagogy and features, including quizzes,multiple choice questions, vignettes/case studies andactivities * Features a companion website with links to further reading,additional activities and resources, and self-testing interactivemultiple choice questions Fundamentals of Palliative Care for Student Nurses focuses on this area with expert knowledge and compassion,preparing students in order to help them provide the best possiblecare for their patients and their families.

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Table of Contents

Titles of related interest

Dedication

Title Page

Copyright

About the series

The Authors

Megan Rosser RGN, DN cert, BSc (Hons) MSc (London) PG Cert Learning and Teaching

Helen C Walsh SRN, RM, RHV, Dip HE Business Administration, MSc, PGCert Education

Acknowledgements

Preface

About the companion website

Section I: The principles of palliative care

Chapter 1: The development of palliative care

Introduction

What is palliative care?

Where is palliative care provided?

Widening access

Palliative care for older people

People living with learning disabilities

Black and ethnic minorities

Influential documents and strategies

Conclusion

References

Chapter 2: Holistic care in palliative care

Introduction

Total pain

Holism

Holistic care

Spirituality

Quality of life

Conclusion

References

Chapter 3: Team working

Introduction

What is a team?

Why is interprofessional team work important in palliative care?

What makes a team work well?

What stops a team from working well?

Conclusion

References

Chapter 4: Legal principles in palliative care

Introduction

Identification of legal issues surrounding the provision of palliative care

Consent

Best interests

Withholding and withdrawing treatment

Do not resuscitate orders (DNR)

Euthanasia and assisted suicide

Verification of death

Conclusion

References

Chapter 5: Ethical principles in palliative care

Introduction

The meaning of ethics

Ethical theories

Conclusion

References

Section II: The practice of palliative care

Chapter 6: Communication in palliative care

Introduction

The importance of communication in palliative care

Communication theory

The importance of self-awareness in good communication

Key communication skills

Enablers of and barriers to good communication

Influencing factors

Communicating with groups who have particular needs

Conclusion

References

Chapter 7: Pain management and nursing care

Introduction

Pain

Pain assessment

Non-pharmacological approaches to pain relief

Conclusion

References

Chapter 8: Management and nursing care of gastro-intestinal symptoms

Introduction

Nausea and vomiting

What is nausea and vomiting?

Assessment

Management of nausea and vomiting

Nursing care

Malignant bowel obstruction

Constipation

Cachexia

Other gastrointestinal symptoms

Conclusion

References

Chapter 9: Management and nursing care of breathlessness and fatigue

Introduction

Breathlessness

What is breathlessness?

Assessment of breathlessness

Pharmacological Management of breathlessness

Nursing management

Fatigue

What is fatigue?

Assessment

Management of fatigue

Nursing care

Conclusion

References

Chapter 10: Management and nursing care of psychological symptoms

Introduction

Psychological concerns

Depression and Anxiety

Management and treatment of anxiety and depression

Sexuality

Assessing sexuality

Psychological care

Conclusion

Chapter 11: Caring for the family

Introduction

Defining the family

Role of the family in care giving

Effects of caring on the family

The needs of carers

Communicating with the family

Conclusion

References

Chapter 12: Palliative care emergencies

Introduction

Palliative care emergencies

Spinal cord compression

Superior vena cava obstruction (SVCO)

Hypercalcaemia

Conclusion

Chapter 13: Nursing care at end of life

Introduction

Recognising that a patient is dying

End of life care

Physical nursing care for the dying patient

Bronchial secretions (‘death rattle’)

Terminal restlessness

The syringe driver

Being with a dying patient

Nurse's role after death

Conclusion

References

Chapter 14: Loss grief and bereavement

Introduction

Coping With Loss

Common emotional responses to loss

Bereavement theories

Helping the bereaved

Conclusion

References

Section III: Personal and professional development in palliative care

Chapter 15: Looking after yourself

Introduction

What is stress and why do we need to know about it?

Some of the reasons nursing is stressful

Effects of stress

Coping strategies

Conclusion

References

Chapter 16: Professional support

Introduction

Key people

Clinical supervision

Conclusion

References

Chapter 17: Learning from your practice through reflection

Introduction

Types of reflection

Why use reflective practice?

Starting your reflective practice

Conclusion

References

Index

End User License Agreement

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Guide

Cover

Table of Contents

Preface

Section I: The principles of palliative care

Begin Reading

List of Illustrations

Figure 1.1

Figure 1.2

Figure 1.3

Figure 1.4

Figure 1.5

Figure 3.1

Figure 3.2

Figure 3.3

Figure 3.4

Figure 3.5

Figure 6.1

Figure 6.2

Figure 6.3

Figure 6.4

Figure 7.1

Figure 7.2

Figure 7.3

Figure 7.4

Figure 7.5

Figure 8.1

Figure 8.2

Figure 9.1

Figure 11.1

Figure 11.2

Figure 11.3

Figure 13.1

Figure 15.1

Figure 15.2

Figure 16.1

Figure 17.1

List of Tables

Table 6.1

Table 6.2

Table 8.1

Table 8.2

Table 8.3

Table 10.1

Table 10.2

Table 10.3

Table 11.1

Table 12.1

Table 12.2

Table 12.3

Table 13.1

Table 13.2

Table 14.2

Table 14.3

Table 15.1

Table 15.2

Table 16.1

Table 17.1

Titles of related interest

This book is dedicated to all the patients and families we have been privileged to work with during our careers; with immense gratitude for all that they taught us.

FIRST EDITION

Fundamentals of Palliative Care for Student Nurses

Authored by Megan Rosser and Helen C Walsh, with contributions from Chantal Patel

MEGAN ROSSER

Director for CPD/Non Professional Undergraduate Programmes, College of Human and Health Sciences, Swansea University

AND

HELEN WALSH

Senior lecturer, College of Human and Health Sciences, Swansea University

This edition first published 2014 © 2014 by John Wiley & Sons Ltd

Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK

The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of Congress Cataloging-in-Publication Data

Fundamentals of palliative care for student nurses / edited by Megan Rosser, Helen Walsh.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-118-43780-3 (pbk.)

I. Rosser, Megan, editor. II. Walsh, Helen, 1957- editor.

[DNLM: 1. Nursing Care--methods. 2. Palliative Care--methods. 3. Terminal Care--methods. WY 152.3]

R726.8

616.02'9--dc23

2014004008

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

About the series

Wiley's Fundamentals series are a wide-ranging selection of textbooks written to support preregistration nursing and other healthcare students throughout their course. Packed full of useful features such as learning objectives, activities to test knowledge and understanding, and clinical scenarios, the titles are also highly illustrated and fully supported by interactive MCQs, and each one includes access to a Wiley E-Text: powered by VitalSource–an interactive digital version of the book including downloadable text and images and highlighting and note-taking facilities. Accessible on your laptop, mobile phone or tablet device, the Fundamentals series is the most flexible, supportive textbook series available for nursing and healthcare students today.

The Authors

Megan Rosser RGN, DN cert, BSc (Hons) MSc (London) PG Cert Learning and Teaching

Megan began her nursing career at Charing Cross Hospital and qualified as a Registered General Nurse in 1985. Since then she has specialised in oncology and in palliative care, spending time in her early clinical years at the Royal Marsden and St. Francis Hospice Romford. The last 7 years of her clinical practice were spent as a community Macmillan nurse in West Essex. Megan moved into education in 1999 and worked at St. Christopher's Hospice, Kings College London and the Macmillan National Institute for Education before moving to Swansea 10 years ago. Megan is currently the Director for continuing professional development in the College of Human and Health Sciences at Swansea University and has previously published in the areas of cancer nursing, palliative care, action research, transition experiences, mentorship and evidence based practice.

Helen C Walsh SRN, RM, RHV, Dip HE Business Administration, MSc, PGCert Education

Helen started her nursing career at the Royal Masonic Hospital and qualified as a State registered Nurse in 1979. After a brief spell working in Urology Helen trained as a midwife and then pursued a career in cardio-thoracic nursing for 3.5 years. After training as a health visitor Helen moved into the area of palliative care nursing, working in a number of increasingly senior posts at St. David's Foundation in Newport before taking up the post of Senior Macmillan Nurse at Ty Olwen Palliative Care Service in Swansea. Helen moved into nurse education in 2005 and is currently a senior lecturer in the College of Human and Health Sciences at Swansea University, her particular areas of interest include communication, clinical supervision, portfolio development and learning through patchwork texts. Helen has previously published works in the areas of palliative care and bereavement care and has presented at a number of conferences.

Acknowledgements

Megan would like to thank her partner Sue Waite for her unfailing belief, support and encouragement.

Helen would like to acknowledge Jen and Fran for their support, encouragement and love.

Preface

The aim of palliative care is to improve the quality of life of people living with serious chronic illnesses such as cancer, cardiac failure, Alzheimer's disease and renal failure. Traditionally, palliative care was considered only to be needed by patients living with cancer but thankfully it has long been acknowledged that palliative care should be available to all people in need, regardless of their diagnosis. Palliative care is holistic care and addresses people's physiological, social, emotional and spiritual needs as well as their physical needs. Good fundamental ‘general palliative care’ can be provided by any knowledgeable health care professional; relatively few people require specialist palliative care provided by specialist teams.

Whilst primarily aimed at student nurses, it is our belief that this book also contains useful information for registered nurses who wish to learn more about palliative care. This book seeks to provide you with an introduction to the main principles and theories of palliative care in order to give you the basic essential knowledge to enhance your confidence in caring for people with palliative care needs. The first section of the book introduces you to the development of palliative care practice, focussing on the underpinning principles; the second section considers how these principles apply in clinical situations in order to achieve optimal care and quality of life for patients and their families. The third and final section focuses on your continued development in the practice of palliative care.

In keeping with the philosophical approach of the series we have tried to make the book as interactive as possible. Throughout the book there are a number of activities for you to undertake, encouraging you to take time out from reading to think about your current practice and to consider how new knowledge gained from this book might develop your nursing care. In order to help you apply the information in the book to your own practice we have tried to give clinical examples wherever possible; there are patient scenarios in most chapters. There are opportunities at the end of many chapters to test your learning and the companion website presents short MCQs for each chapter to enable further self-assessment of learning.

The term patient is used throughout the text in preference to ‘service user’, ‘client’ or ‘consumer’ because of familiarity and ease of use. Whilst the term ‘patient’ may have negative connotations for some health care professionals it is still the most commonly used term and the most easily understood and is therefore felt by us to be the most appropriate. True patient centred palliative care should overcome the imbalances of power perceived by some to be associated with the term patient.

About the companion website

This book is accompanied by a companion website:

www.wiley.com/go/rosser_walsh/fundamentals_of_palliative_care

The website includes:

nteractive MCQs for self-assessment

Useful online resources

Part IThe principles of palliative care

Chapter 1The development of palliative care

Introduction

This chapter explores the history and development of palliative care from the early days of the hospice movement through to the development of specialist palliative care and end of life care. It will track the extension of palliative care beyond cancer diagnosis, which is underpinned by the principle of provision of care according to need, not diagnosis. The differences between palliative care and other areas of care will be explored. The provision of palliative care for patients in minority groups is considered as well as the policies and strategies that have shaped the development of the speciality.

Learning outcomes

By the end of this chapter you will be able to

identify key events in the development of hospice and palliative care;describe palliative care and specialist palliative care;identify the key principles of palliative care;discuss the provision of palliative care across care settings;discuss the extension of palliative care services beyond cancer diagnosis;discuss some of the challenges facing hard-to-reach groups requiring palliative care.

What is palliative care?

Simply put, palliative care ‘focuses on the relief of pain and other symptoms and problems experienced in serious illness. The goal of palliative care is to improve quality of life, by increasing comfort, promoting dignity and providing a support system to the person who is ill and those close to them.’ (dying matters 2012).

Since the development of St Christopher's hospice in 1967, the growth of palliative care has been driven by charities, health care providers and government policy. The significant early developments and key policies are presented in Figures 1.1 and 1.2.

Figure 1.1 The early development of palliative care services in the United Kingdom.

Figure 1.2Key policy developments in palliative care in the United Kingdom.

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!